Anxiety and depression propensities in patients with acute toxic liver injury

AIM:To investigate anxiety and depression propensities in patients with toxic liver injury.METHODS:The subjects were divided into three groups:a healthy control group(Group 1,n=125),an acute non-toxic liver injury group(Group 2,n=124),and a group with acute toxic liver injury group caused by noncommercial herbal preparations(Group 3,n=126).These three groups were compared and evaluated through questionnaire surveys and using the Hospital Anxiety-Depression Scale(HADS),Beck Anxiety Inventory(BAI),Beck Depression Inventory(BDI),and the hypochondriasis scale.RESULTS:The HADS anxiety subscale was 4.9±2.7,5.0±3.0 and 5.6±3.4,in Groups 1,2,and 3,respectively.The HADS depression subscale in Group 3 showed the most significant score(5.2±3.2,6.4±3.4 and 7.2±3.4in Groups 1,2,and 3,respectively)(P<0.01 vs Group 1,P<0.05 vs Group 2).The BAI and BDI in Group 3showed the most significant score(7.0±6.3 and 6.9±6.9,9.5±8.6 and 8.8±7.3,10.7±7.2 and 11.6±8.5in Groups 1,2,and 3,respectively)(BAI:P<0.01 vs Group 1,P<0.05 vs Group 2)(BDI:P<0.01 vs Group1 and 2).Group 3 showed a significantly higher hypochondriasis score(8.2±6.0,11.6±7.5 and 13.1±6.5in Groups 1,2,and 3,respectively)(P<0.01 vs Group 1,P<0.05 vs Group 2).CONCLUSION:Psychological factors that present vulnerability to the temptation to use alternative medicines,such as herbs and plant preparations,are important for understanding toxic liver injury.     

Toxic Shock Syndrome in Plastic Surgery Patients: Case Report and Review of the Literature

Toxic shock syndrome (TSS) is a rapidly developing disease, which may be lethal if not recognized and treated early. TSS unrelated to menstruation comprises an increasing proportion of the cases reported to the Centers for Disease Control during recent years, and a review of the literature reveals that TSS has is reported with increasing frequency in plastic surgical patients as well. The majority of reports relates to aesthetic plastic surgical procedures such as rhinoplasty, augmentation mammaplasty liposuction, and chemical peeling, but cases of TSS following reconstructive breast surgery with musculocutaneous flaps have also been reported. A common denominator seems to be that TSS occurs unexpectedly in healthy patients. Nonmenstrual TSS is apparently associated with a higher mortality rate than TSS associated with menstruation. We report on a case of TSS after exchange of silicone implants and resection of a siliconoma in a 59-year-old woman. Details of the case and a review of the literature are presented.     

Pathogenesis of the toxic shock syndrome: T cell mediated lethal shock caused by the superantigen TSST-1

The pathogenesis of the toxic shock syndrome (TSS) is only incompletely understood. We now present evidence that TSS toxin-1 (TSST-1), one of the superantigens produced by Staphylococcus aureus, induces lethal shock in D-galactosamine sensitized mice. In this model TSS is dependent on T cells, since cyclosporin A (CsA) completely blocked development of shock, and since T cell-deficient SCID mice did not show signs of disease upon injection with TSST-1. However, SCID mice repopulated with T cells succumbed to lethal shock. The disease is characterized by a burst of lymphokines like interleukin-2 (IL-2) and tumor necrosis factor (TNF) released into the sera of TSST-1-treated animals. Already 1–2 h after TSST-1 application TNF serum levels peaked and IL-2 levels peaked around 4 h after treatment. TNF appears as key mediator of TSS, because anti-TNF monoclonal antibodies protected TSST-1-challenged mice. Interestingly, the burst of TNF in serum was noted well in advance of detectable markers of T cell activation. Thus, about 5 % of all peripheral T cells started to express the IL-2 receptors as late as 4 h after treatment. Comparing TSST-1- and endotoxin-induced shock we conclude that TNF effects shock in both diseases. However, the type of cells involved appears distinct in that T cells cause TSS triggered by the exotosin TSST-1 while macrophages mediate the shock induced by endotoxins.     

Exposure to lead and other metals in children from Katowice district, Poland

Objectives: To assess the exposure to toxic metals and to evaluate its possible association with essential elements and socioeconomic status in children from the town of Bytom in the Katowice area; this area is one of the most polluted industrialized regions in Poland. Methods: Concentrations of lead, cadmium, mercury, selenium, magnesium, copper, and zinc were determined in whole blood of 211 children aged 9 years. The samples were analyzed using inductively coupled plasma mass spectrometry (ICP-MS). Information on socioeconomic factors was collected using questionnaires. Concentrations of trace elements in the blood of 24 Swedish children aged 9–10 years were used for comparisons. Results: The concentrations of lead detected in the blood of the Polish children ranged from 0.09 to 1.9 μmol/l, with the median value being 0.27 μmol/l. Statistically significant associations were found between lead and such socioeconomic factors as the number of siblings, trips outside the region, maternal smoking, playing outdoors, and apartment standard. The average blood lead level was about 3 times higher in the Polish children than in the Swedish group. The median blood concentration of cadmium found in the Polish children was 3.4 nmol/l (range 1.1–41 nmol/l; almost 3 times higher than that detected in the Swedish children), and that of mercury was 3 nmol/l (range 0.5–11 nmol/l). The median blood levels and ranges of the essential elements were 1.1 (0.7–2.0) μmol/l for selenium, 1.5 (1.2–1.9) mmol/l for magnesium, 17 (13–22) μmol/l for copper, and 78 (54–104) μmol/l for zinc, respectively. The concentrations of selenium and magnesium were significantly lower in the Polish group as compared with the Swedish children. Conclusions: In all, 7% of the Polish children had blood lead levels exceeding 0.5 μmol/l, the concentration above which negative effects on mental development have been reported. However, the findings indicate a decrease in lead exposure during recent years among the Bytom children. Received: 26 June 1997 / Accepted: 28 August 1997     

海洛因中毒神经系统损害的影像研究

目的 探讨海洛因中毒引起中毒性脑病脑部影像学特点.方法 对37例海洛因中毒患者进行头颅CT/MRI检查分析.结果 海洛因中毒脑病的脑部影像改变呈多样性,可表现为正常、轻度脑萎缩、对称性大脑半球的脑白质、内囊后肢、小脑齿状核病变.结论 海洛因中毒性脑病可因不同机理而出现脑部影像表现也不同.     

Necrosis and haemorrhage of the putamen in methanol poisoning shown on MRI

Methanol, a highly toxic substance, is used as an industrial solvent and in automobile antifreeze. Acute methanol poisoning produces severe metabolic acidosis and serious neurologic sequelae. We describe a 50-year-old woman with accidental methanol intoxication who was in a vegetative state. MRI showed haemorrhagic necrosis of the putamina and oedema in the deep white matter. Received: 17 March 1997 Accepted: 15 July 1997     

先天性巨结肠根治术式改进的研究

作者采用自己设计的环牵法治疗先天性巨结肠症患者40例,手术治愈率为97.1％。作者认为环牵法具有治疗效果好,并发症少,死亡率低,操作简便的优点。文中还对本法的治疗原理,手术操作要点等问题作了阐述。     

去甲硫氨酸全肠外营养加5—Fu对胃癌患者毒副作用的研究

探讨去甲硫氨酸全肠外营养加５－Ｆｕ对胃癌患者生化指标和肝肾功能的毒副作用。方法：１５例住院进展期胃癌患者，随机分为Ｍｅｔ ＴＰＮ＋５－Ｆｕ和去Ｍｅｔ ＴＰＮ＋５－Ｆｕ两组，术前分别接受７天肠外营养支持和５天化疗。于治疗前后测肝肾功能，血清总蛋白质，白蛋白，转铁蛋白，前白蛋白和甲硫氨酸，半胱氨酸水平。     

视觉诱发电位监测二硫化碳毒性视网膜病变

目的　探索使用图形视觉诱发电位 (VEP P)早期诊断二硫化碳 (CS2 )中毒性视网膜病变的可能性。方法　选择不同程度接触CS2 5年以上者 1 1 6人 (2 32眼 ) ,并以非接触者 32人 (64眼 )作对照组 ,检测P VEP,并根据接触的不同方式及浓度分组研究。比较各组VEP PP1 0 0 波波幅及潜伏时、潜时值差、波幅差值及A/L值。结果　每日长时间接触CS2 的中、低浓度组的VEP PP1 0 0 波波幅 (8.37±3 .2 0 ) μV及 (7.95± 3.34) μV ,较非接触组的 (9.64± 3.2 5) μV明显下降 (P <0 .0 5;P <0 .0 1 ) ,其A/L值降低。结论　VEP P有助于CS2 中毒性视网膜病变及视神经病变的早期诊断     

恙虫病并发肝损害25例

目的：探讨急性盖虫病并发肝损害的临床特点。方法：按诊断标准选择病例进行临床分析。结果：本组除了具有盖虫病特征性临床表现外，同时出现黄疸占28％，出血点和瘀斑占16％，肝肿大占88％，脾大占64％。ALT、AST升高。使用特效抗菌药物和护肝退黄治疗效果良好。结论：恙虫病并发肝损害较常见，少数可出现严重的肝功能损害。